Joshua M. Smyth, a professor of behavioral health and medicine at Penn State University, spoke about ambulatory and real-time intervention in daily life to the Colorado State University community on Monday in the Behavioral Sciences Building.
Smyth’s studies have led him to focus mainly on the effects of stress on well-being and the processes by which people deal with stress.
Currently, he is researching new intervention methods specific to triggers, such as stress, addiction and habit.
“I can ask you right now how you’re feeling, and figuratively flip through that and see a movement of your dynamic state,” Smyth said, comparing data to a flipbook.
By observing a large portion of data over a short period of time it is possible to use that information to structure interventions in response to context, said Smyth.
Smyth said that historically the reach of implementation of intervention was extremely narrow—beginning with face-to-face diagnoses. Over time, face-to-face become phone, to audio, to video and finally to mobile devices, or mobile health, referred to as mHealth.
Smyth uses this new technology to not only asses, but intervene throughout the day. He uses structures based on patterns and implements them “just in time.”
“The context is changing,” Smyth said. “You start to cut up these little slices of life into ways that are relevant.”
Ecological momentary assessment or the process of sampling based situationally is mainly carried out by self-reporting. By incorporating this into intensive longitudinal data tests, or tests with repeated measurement over a short period of time, they show ecological validity, Smyth said.
Smyth discussed differences in between-person and within-person validity to show how people differ from each other on average, how we differ from ourselves over time, and how we differ from each other on how much we differ from ourselves.
“You take lots of assessments of stress on lots of people, and now I can start to say ‘why are these people more or less variable?’ We can start to use these sources of information to unpack it,” Smyth said.
Smyth stressed that inferences about some person cannot be made based on information from another, because people are variable. Through understanding of these internal variables, adaptive interventions can be formed specific to a person. Smyth referred to this as ecological momentary intervention.
Implementation complexity is variable in accordance. It can include anything from simple rules, fixed rules, dynamic rules and dynamic processes, Smyth said. All of these relate to reminders, extensions and reach in response to some trigger.
“It allows you to think of ways where you can ideographically tailor interventions to moments of risk,” Smyth said.
Through these procedures, Smyth studied obesity and stress and found that in obesity EMI increased daily steps by over a thousand, and reported stress was cut in half from the average level.
Smyth, however, recognized the growing points or risk factors for this method, including the lack of reliability of self-reporting and high start-up costs. Yet, he believes this method is a great option for tracking and adapting to individuals and their specific diagnoses.
“Interventions differ in how you need or even the capacity to break them up,” Smyth said. “I think the idea is if you capture these data you can use them to design theoretically and clinically informative interventions and get the right stuff to the right people at the right time.”
Collegian reporter Audrey Weiss can be reached at news@collegian.com or on Twitter @Audkwerd.
